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Ulnar neuropathy and dystonic flexion of the fourth and fifth digits: Clinical correlation in musicians
Author(s) -
Charness Michael E.,
Ross Marjorie H.,
Shefner Jeremy M.
Publication year - 1996
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.880190403
Subject(s) - ulnar neuropathy , ulnar nerve , medicine , elbow , dystonia , focal dystonia , peripheral neuropathy , surgery , physical medicine and rehabilitation , endocrinology , psychiatry , diabetes mellitus
Peripheral nerve lesions are sometimes associated with focal dystonia. We diagnosed ulnar neuropathy in 28 of 73 (40%) cases of occupational cramp in musicians. Focal slowing of ulnar conduction across the elbow was identified in 15 of 19 (79%) patients using the near nerve technique and in 5 of 17 (29%) patients using surface recording. Ulnar neuropathy was present in 24 of 31 (77%) cases with flexion dystonia of the fourth and fifth digits and only 4 of the remaining 42 (10%) cases with other patterns of focal dystonia. Focal dystonia improved in 13 of 14 patients whose ulnar neuropathy improved and appeared or worsened in 2 patients following ulnar nerve injury. These data, together with our recent observation of a dystonic pattern of antagonist bursting in patients with isolated ulnar neuropathy ( Muscle Nerve 1995;18:606–611), suggest that ulnar neuropathy may initiate or sustain a specific dystonia, flexion of the fourth and fifth digits, by inducing a central disorder of motor control. © 1996 John Wiley & Sons, Inc.